Adventures in Leadership

Adventures in Leadership

Center for Leadership 2990 CB Elon, NC 27244 (336) 278-5323

DATE

Dear Adventures in Leadership Participant,

Congratulations! You have been enrolled in Adventures in Leadership the week of June

21st-June 26

th or June 28

th- July 3

rd The Elon University Adventures in Leadership staff is

eagerly awaiting your arrival. Enclosed is a packet of information providing details of the

program. Please pay special attention to times, dates, and the items you will need to

bring.

You should find the following enclosed in this packet:

Personal Data Form

Frequently Asked Questions Sheet

Timeline Sheet

Get to Know You Form

Consent Forms (Rafting, Rock Climbing, Elon Challenge Course &

Elon University Travel)

Map of Campus & What to Bring List

Please visit the Adventures in Leadership website http://www.elon.edu/e-

web/students/leadership/adventures/ to complete the registration packet. The forms and

the remaining balance of $325 must be completed and sent in by May 21st.

Additionally, Health Forms are due to the Health Center at this time (Health Forms

can be accessed at www.elon.edu/health in the left hand bar =>Immunization Forms

=>Undergraduate PDF ). Please make your checks payable to Elon University—

Adventures in Leadership, and mail checks and completed forms to:

Elon University

Center for Leadership

2990 Campus Box

Elon, NC 27244

Attn: Adventures in Leadership

For updated information, please check our website at: http://www.elon.edu/adventures. If

you have any questions or comments, please call (336) 278-5323.

Sincerely,

Brandon MacCallum and Steve Mencarini

Adventures in Leadership Directors

http://www.elon.edu/e-web/students/leadership/adventures/

http://www.elon.edu/e-web/students/leadership/adventures/

http://www.elon.edu/health

http://www.elon.edu/adventures



Health History Forms: Participants’ Elon University Health History Forms (located at www.elon.edu/health , on the left hand side there will be a sidebar labeled Immunization Forms-it is a drop down box; from there click on Undergraduate PDF) the form must be returned completed to R.N. Ellington Health Services postmarked no later than May 21st, 2013. Participants who do not have a Health History Form on file with the University on the date their trip begins will not be permitted to participate in the Adventure. Please send Immunization Forms to the following address (if you have not already done so):

R.N. Ellington Health Services C/o Kitty Parrish 2040 Campus Box Elon, NC 27244 Attn: Adventures in Leadership

Flight Arrangements: If you are flying in, please plan on arriving in Greensboro or Raleigh by 12:00 noon on the Friday of your specific trip. The airport shuttle will be at the airports from 10:00 am- 12:00 pm to pick up participants. A member of our staff will be there to greet you at the baggage claim. The departure airport shuttles will leave from Elon on Wednesday afternoon; please plan your departure flights on Friday for 2:00 pm or later.

Transportation needs: At which airport will you arrive and depart? Greensboro (GSO) Raleigh (RDU)

Arrival flight #___________ Airline: _______________ Time: _________ Date: _________ Departure flight #_________ Airline: _______________Time: _________Date: __________

http://www.elon.edu/health



Frequently Asked Questions

Q. Is lunch provided the first day of the adventure? A. No, please eat before you arrive. If you are flying in, the airport shuttle will stop at a fast food restaurant on the way to Elon. You should bring money to pay for this stop. All other meals are included.

Q. What should we be wearing upon arrival? A. The Adventure begins upon arrival at Elon. Dress appropriately to be outside in hot weather (sunshine or rain). Q. Are there shuttles from the regional airports? A. Yes, there will be free shuttles to pick up students who are flying in. Please make your arrival time in Greensboro or Raleigh before 12:00 noon on Friday, June 21st or Friday, June 28th. A return shuttle will depart from Elon Wednesday morning, so returning flights should be scheduled for 2:00 pm or later on Wednesday, June 26th or July 3rd. If you need transportation to or from the airport, please include your flight information on the data form, or call in your information if it is not available when you return your paperwork. Q. Where is check-in? A. Registration will be held at the Harden Clubhouse on South Campus. The location of Harden Clubhouse can be founded highlighted on the enclosed map. Q. When is check-in? A. Friday, June 21st or June 28th from 12pm – 2pm.

Getting to Know You!

Name:_______________________________ The following questions will help us to get to know you better before you arrive. Please attach a second sheet of paper with your answers. Please return with your personal data form by June 8th! 1. What about this experience appeals to you? 2. If you have had a previous adventure like this one, describe it. 3. Since the project requires learning, leading, and working together as a team, what will you contribute to our becoming a team? 4. What type of leader are you? What type of leader do you admire most? 5. How would your friends describe you? 6. Is there anything else that you want to share including any possible anxieties? 7. I will bring a tent If yes, what size?_____________ and a tarp/footprint for the tent(s) 8. Do you have a sleeping bag? Yes No. If not would you like for the University to provide one for you?____________________________________________________________

** Please attach a picture of yourself to this form**



Tentative Timeline

Friday Arrive between 12:00pm and 2:00pm at the Harden Clubhouse located on South Campus; the adventure will begin promptly at 2:00pm Check-in, introductory activities, tour of campus, and camping on the Elon Challenge Course

Saturday Elon Challenge Course Depart for West Virginia Mountains and set up camp

Sunday

Rock Climbing/Hiking

Monday

Day 1 on the New River Camp on the banks of New River

Tuesday

Day 2 on the New River Return to Elon

Wednesday Closing Participant Banquet Pick up of students and airport shuttles beginning at 12:00pm Participants flying out should schedule departure flights no earlier than 2pm

If you have any questions, please call us at (336) 278-5323

Consent and Release Form

State of North Carolina County of Alamance

I, __________________, do hereby consent to voluntarily participate in activities occurring in the summer of

2013; Adventures In Leadership, in accordance with all rules and regulations, a copy of which is attached

hereto and made a part hereof.

I do hereby agree to release and forever discharge Elon University, its officers, agents and employees from any

and all suits, claims, demands, liabilities, costs, and expenses, including reasonable counsel fees, which result

from or may arise out of my participation in the aforesaid activity.

During my participation in this activity, I hereby grant the University, its employees and agents full authority to

take whatever actions they may consider to be warranted under the circumstances regarding the protection of

my health and safety, and I hereby release each of them from any liability for any such decisions or actions as

may be taken by them in connection therewith. The authority granted in the preceding sentence shall include

the right to place me, at my own expense, and without any further consent in a hospital for medical services and

treatment, or if no hospital is readily accessible, to place me in the hands of local medical doctor for treatment.

I have read and understand all rules and regulations and hereby agree to comply with all rules, standards, and

instructions in relation to this activity, which are promulgated by the University. I agree that the University, its

employees, and agents shall have the right to enforce appropriate standards of conduct, and that the University

may, at any time, terminate my participation in this activity in event of any failure to abide by such rules and

regulations.

I hereby acknowledge that the University reserves the right to make cancellations, substitutions, or changes in

this activity.

_______________________________________ _________________

Participant (print name) Date

_______________________________________

Participant Signature

_______________________________________ _________________

Signature of Parent of acting Legal Guardian (if minor) Date

The Elon Challenge Elon University

Consent and Release of Liability

By signing below, I affirm my understanding that the events of The Elon Challenge experience are physically challenging activities, which include

warm-ups, games, group initiative problems and use of a low and/or high challenge course. These are held in a wooded area where I may be exposed

to certain risks such as inclement weather, insect bites, poison ivy/oak, etc. I understand that although the instructor has received training in Elon

University challenge courses, it is impossible to guarantee absolute safety and my safety is ultimately my responsibility. I have the responsibility to

decide whether I will participate in any event. I understand that the program is physically and mentally demanding and I am not aware of any reason

why I should not participate.

I assume all risks and release Elon University (town and institution) and their instructors from all liability whatsoever for any injuries and/or

accidents in connection with my participation in the ropes course experience. I intend this consent and release liability to be binding not only for

myself but also for my family and all legal successors.

Should emergency medical treatment be deemed necessary and I am unable to consent to treatment, I hereby authorize the ropes course instructors to

secure proper treatment and take necessary medical actions to treat me.

Signature of Participant Date

Signature of Parent/Guardian if minor (under 18) Date

Please initial here if you are NOT comfortable being photographed or filmed for marketing purposes

_______

Medical Information

Please check all conditions that apply to participant.

____ Heart Condition ____Diabetes ____Pregnancy ____Asthma

____High Blood

Pressure ____Epilepsy ____Anemia ____Anxiety

Do you have allergies to insect bites? ____ bee stings? ____ other allergies? ____ (please specify)

________________________________________________________

Do you carry medication for any of the above? (please list)

_______________________________________________________________________

Are you currently taking any medications? (please list all prescribed and over the counter)

No ____ Yes (identify and explain)

________________________________________________________________________

Do you have any pre-existing limitations (specify)

__________________________________________________________________

Personal Information

Participant’s Name________________________________

Organization/class/business___________________________________

Phone #______________________________________________

Email_____________________________________________

Home Address_________________________________________

City/State/Zip_______________________________________

Please specify the time and date you will be on the Elon Challenge Course

_______________________________________________

Emergency Contact Name: ______________________________

Phone # (__)_________________________________________

Name of Physician: ___________________________________

City/State _________________________________________

How many times have you been on the Elon Challenge Course not including today’s

experience?_______________

CONTRACT & LIABILITY WAIVER & INDEMNIFICATION AGREEMENT I am aware that during the river or mountain biking trip (and associated base camp or other activities such as lodging,

camping, kayaking, mud obstacle course, hiking, swimming, horse riding, climbing, zip line tours, caving, ropes course,

paint ball, snow tubing, ATV, lake activities, including Aqua-Jump, etc, in which I am participating under the arrangement

of American Canadian Expeditions, Ltd., dba ACE Whitewater, aka ACE Adventure Resort, Wildwater Expedition

Unlimited or North American River Runners (and/or associated companies including but not limited to: Mountain Cove,

Inc., Adventure Expeditions, Inc., Riverworks, Inc., Gauley Outdoor Center, Inc., Montgomery’s Outdoor Adventures),

their agents, employees, associates, and equipment manufacturers, certain substantial risks and dangers may occur,

including, but not limited to:

• hazards of traveling on a raft, canoe or kayak in

normal, rough or flooded river conditions

• hazards of walking on railroad tracks (trains can be

hard to hear in river gorges),

• attacks from wild or domesticated animals,

• hazards of jumping, diving or being thrown into

unfamiliar water with submerged hazards,

undercut rocks, and manmade hazards,

• hazards of rafts flipping or dumping guests

• hazards of long, cold swims,

• hazards of being pinned under and/or against

trees, rocks, rafts or other objects,

• contact with paddles, helmets, other guests or

guides, food boxes or other containers,

• diseases from contaminated water,

• allergies from cleaning reagent,

• hazards of hiking, biking or horseback or ATV

riding in rough

terrain,

• disease,

• strains or sprains,

• fractures or punctures,

• partial and/or total paralysis,

• loss or damage to personal property,

• snake bites, insect bites and bee stings, (the

above listed companies rarely carry

medications),

• illnesses, or injury in remote places without

medical facilities,

• failure of or lack of communication equipment,

• failure or lack of safety equipment,

• injuries occurring in rescue operations (rafts

may bump other rafts, ropes may cause

entanglements, rocks may be slippery),

• entrapment in caves,

• falls from man-made and natural cliffs,

• hazards of entering and leaving the raft,

• hazards of loading or unloading people or

materials from vehicles,

• hazards from the force of nature,

• falling limbs or trees,

• problems or hazards related to travel by

automobile, bus, ATV or other conveyance (vehicle

accidents),

• problems or hazards related to consumption of alcoholic

beverages by anyone,

• being struck by falling people,

• death,

• accidents,

• drownings,

• entrapment in rafts,

• slippery mud,

• eye injuries including blindness,

• equipment malfunction (paddles may break, rafts

may come apart, etc.),

• frostbite or other cold related injuries,

• heat stroke, sunburn,

• briers and thorns,

• lightning,

• explosions (gas grills),

• fresh water amoeba infection,

• criminal acts,

• falls from elevated ropes, platforms or other

structures or features

and that these risks and dangers may be caused by the negligence of the owners, employees, officers or agents of the

above listed companies, negligence of others, accidents, breaches of contract, the forces of nature or other causes.

These risks and dangers may arise from foreseeable or unforeseeable causes including that a guide may

misjudge terrain, weather, trail or river route location or water level and may be unaware of your fitness or

abilities. Staff may give incomplete warnings or instructions. Decisions by guides or company staff are part of

the inherent risk of rafting and of other activities. In consideration of and as part payment

Any alteration to this waiver will prohibit the participation in all activities.

PAGE 1 OF 4 PAGES (READ & RETURN ALL 4 PAGES)

for the right to participate in such river and land activities and the services, food and alcoholic beverages, if any, arranged for me by the above listed companies, its agents, employees and associates, I have and do hereby assume all of the above risks, and release, and will hold harmless, the above listed companies, their agents, employees, associates and associated companies, or any other person from any and all liability, actions, causes of action, debts, claims and demands of every kind and nature whatsoever which I now have or which may arise out of or in connection with my trip or participation in any of the base camp or related activity. I further give permission for use or sale of any photograph or video showing me without further compensation to me. The terms hereof shall serve as a release, contract, indemnification (allowing collection of legal fees from plaintiffs), indemnification by parents or guardians (reimbursement of awards and legal fees in a winning suit brought by the minor or other parent), and assumption of risks for my heirs, executors and administrators and for all members of my family, including, minor’s parents, any minors accompanying me.

I certify that I will not hold the above listed companies, their agents, employees or associated companies responsible for actions of independent or quasi-independent providers of activities which have been arranged for me by, or recommended to me by the afore listed entities. I am participating for enjoyment or thrills and understand that the activities require physical exertion and involve a challenge containing a potential risk of injury or death.

I certify that I will not hold any of the above listed companies, their agents, employees or associated companies responsible for any harm occurring wholly or partially as a result of any existing health problems including, but not limited to:

• reactions to bee stings or the constriction of airways due to cold weather or asthma, • broken bones due to osteoporosis, • hemophilia, • heart disease, • high blood pressure, • pregnancy, • loss of stamina or coherency due to diabetes.

If medical evacuation, including ambulance, Hi-railer, helicopter, due to new or existing medical conditions is arranged by the above listed companies, I agree to reimburse the above listed companies for any charges.

I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers or employees of the above listed companies.

This is a public area in which only minimal security may be provided; the same precautions against crime should be exercised here as anywhere else.

The venue of any dispute that may arise out of this agreement or otherwise between the parties to which the above listed companies or their agents is a party shall be the Fayette County Court in Fayetteville, WV. If any portion of this contract and release is found to be invalid, the remainder shall remain in full force.

I HAVE READ THE ABOVE WAIVER AND RELEASE/CONTRACT AND BY SIGNING IT AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE THE ABOVE LISTED COMPANIES & EMPLOYEES FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. I RECOGNIZE THAT I AM FREE NOT TO PARTICIPATE IN ANY ACTIVITIES.


PARTICIPANT RESPONSIBILITIES The West Virginia Whitewater Responsibility Act (WV Code 20-3B-1 through 5) imposes the following duties on participants in whitewater expeditions:

(a) Participants have a duty to act as would a reasonably prudent person when engaging in

recreational activities offered by commercial whitewater guides in this state. (b) No participant may: (1) Board upon or embark upon any commercial whitewater expedition when intoxicated or under the

influence of non-intoxicating beer, intoxicating beverages or controlled substances; or (2) fail to advise the trip leader or the trip guide of any known health problems or medical

disability and any prescribed medication that may be used in the treatment of such health problems during the course of the commercial whitewater expedition. Do you have any health related issues that could affect you or other persons on the trip that you would like to discuss with the trip leader? (Ex: bee stings, allergies, asthma, heart problems, prescribed medications, injuries, etc.) Yes No

(3) Engage in harmful conduct or willfully or negligently engage in any type of conduct which contributes to or causes injury to any person or personal property; or

(4) perform any act which interferes with the safe running and operation of the expedition, including failure to use safety equipment provided by the commercial whitewater outfitter or failure to follow the instructions of the trip leader or trip guide in regard to the safety measures and conduct requested of the participants; or

(5) fail to inform or notify the trip guide or trip leader of any incident or accident involving personal injury or illness experienced during the course of any commercial whitewater expedition. If such injury or illness occurs, the participant shall leave personal identification, including name and address, with the commercial whitewater outfitters’ agent or employee.

I understand that the Responsibility Act immunizes the outfitter from tort (legal) actions as long as the industry standard of care is met.

West Virginia Bicycle Riders’ Responsibility:

1. West Virginia state law requires all bicyclists fifteen years of age and under must

wear a helmet. ACE/Wildwater/NARR requires that ALL riders wear a helmet. 2. Participants are responsible for all issued rental equipment including but not limited

to damage to bicycle and its corresponding components and helmets. A credit card or other collateral will be held with rental form to cover any damage expenses.

3. The trail map is a general guide only and is not to scale. ACE/Wildwater/NARR cannot be held responsible for inaccurate information or the condition of the trails.

4. All rented equipment will be returned and checked back in at the specified time. If I fail to return by the specified time, I will be charged for the additional time. I agree to wash the bike when I return. After proper return, collateral items will be charged or returned.

5. For rental bikes, the adventure center does not provide shuttle service. In the event that I become lost or the bike breaks down while riding and I request a pick up, and if driver & vehicle is available, then I will be responsible for any and all expenses that incur. If I do not return the bike to the Bike Check Out Area, I agree to pay for the replacement cost.

I HAVE BEEN ISSUED A HELMET AND AGREE TO WEAR IT AT ALL TIMES WHILE

BIKING. (INITIALS)


PLEASE COMPLETE ALL INFORMATION

FIRST NAME LAST NAME

ADDRESS

CITY STATE ZIP

HOME PHONE DATE OF BIRTH BEGINNING DATE OF ACTIVITY

- - - - - -

Has your address changed since your last visit to ACE/Wildwater/NARR? Yes No Would you be interested in receiving an e-mail newsletter containing discounts and specials? Yes No

EMAIL ADDRESS

@ PERSON IN YOUR PARTY THAT MADE YOUR RESERVATION FIRST NAME LAST NAME

NAME AND PHONE NUMBER OF PERSON TO CONTACT IN CASE OF EMERGENCY

(Please list someone not on the trip with you.) Name:

Phone Number:

Relation:

If you found us on the web, what search term did you use to find us?

I agree to personally inspect my helmet, personal flotation device and paddle for any defects before leaving the base camp. The above listed companies do not carry medical insurance. I have read and agree to all the terms in this four (4) page contract.

Signature of Participant (All participants, including minors, must sign here.)

We, the parents or guardians, hereby certify that we have discussed the risks with our child and our child fully understands and comprehends ALL the risks.

Signature of both parents if participant is less than 18 years of age



What to bring

Please pack light (one bag) for the adventure. We will be camping for four nights and five days. Pack for five days of programming. Here is a list of items that you need to bring:

Clothing

1 baseball cap or hat Bandanas Comfortable clothes for 5 days

(please bring a pair of longer shorts for rock climbing)

Bathing Suit Rain Gear/Windbreaker

Gear 1 duffel bag Flash light or head lamp Waterproof sunscreen 30+ Waterproof lip balm 30+ Insect Repellent Sleeping Bag Small pillow Nalgene/Sports Bottle Day Pack (backpack) Trash bag for wet clothes Light Hiking Boots/ Sturdy

Running Shoes (for a short hike on moderate terrain)

River Sandals/Old tennis shoes (i.e. Tevas, Chacos, something that will not fall off)

Sunglasses

Toiletries Toothbrush Small tube of toothpaste Towel

Shampoo/Conditioner (travel

size bottles) Small soap/body wash

Face wash

Miscellaneous

Medications (if epi-pen or inhaler bring two…The raft guide wants to carry one as well)

Optional

Digital/disposable waterproof camera, pack in Ziploc bag to keep dry

Tent and tarp Money for:

Group picture on the rapids ($15)

T-shirt ($20) Video/DVD of trip

($15) iPod/Cell Phone*

*cell phones cannot be utilized for most of the trip but are helpful during travel.

Do NOT bring Alcohol Drugs Weapons Valuable or irreplaceable jewelry Electronic devices (radio, hair

dryer, etc.)

*Elon is not responsible for any equipment you bring with you.

Documents

Adventures in Leadership